Neuropsychiatric Manifestations of Patients With Cushing's Syndrome: Relationship to Cortisol and Adrenocorticotropic Hormone Levels

doi:10.1001/archinte.1981.00340020077021

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Vol. 141 No. 2, February 1981

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Neuropsychiatric Manifestations of Patients With Cushing's Syndrome

Relationship to Cortisol and Adrenocorticotropic Hormone Levels

Monica N. Starkman, MD; David E. Schteingart, MD

Arch Intern Med. 1981;141(2):215-219.

Abstract

• Thirty-five consecutive patients with Cushing's syndromewere studied prospectively before treatment. A consistent constellationof neuropsychiatric disturbances was found, including impairmentsin affect (depressed mood and crying), cognitive functions (decreasedconcentration and memory), and vegetative functions (decreasedlibido and insomnia). Thirty-four percent of patients were ratedas having a mild, 26% a moderate, 29% a severe, and 11% a verysevere psychiatric disability. A statistically significant relationshipwas found between the overall neuropsychiatric disability ratingand cortisol and adrenocorticotropic hormone (ACTH) levels.Patients with adrenal adenomas with high cortisol but low ACTHlevels did not have as severe a neuropsychiatric disability.

(Arch Intern Med 141:215-219, 1981)

Author Affiliations

From the Departments of Psychiatry (Dr Starkman) and Internal Medicine (Division of Endocrinology and Metabolism and the Metabolism Research Unit) (Dr Schteingart), University of Michigan Medical Center, Ann Arbor.

Footnotes

Accepted for publication March 31, 1980.

Reprint requests to Director, Consultation-Liaison Program,Department of Psychiatry, University of Michigan Medical Center,Ann Arbor, MI 48109 (Dr Starkman).

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